Using Community Health Workers to Address Barriers to Participation and Retention in Diabetes Prevention Program: A...

Area of Science:

• Public Health
• Health Disparities
• Chronic Disease Prevention

Background:

• Type 2 diabetes is a growing public health concern, particularly among high-burden populations.
• The National Diabetes Prevention Program (DPP) lifestyle change program is effective but faces participation and retention challenges.
• Social determinants of health significantly impact individuals' ability to engage in preventative health programs.

Purpose of the Study:

• To identify barriers to participation and retention in the DPP lifestyle change program among high-burden populations.
• To evaluate the role of Community Health Workers (CHWs) in mitigating these identified barriers.
• To inform strategies for improving access and adherence to diabetes prevention programs.

Main Methods:

• A systematic literature review was conducted following PRISMA guidelines.
• Scopus and PubMed databases were searched for peer-reviewed articles published between 2010 and 2020.
• Qualitative synthesis was performed on 18 selected articles from an initial pool of 131.

Main Results:

• Key barriers identified include time, cost, transportation, technology access, caregiver responsibilities, health literacy, and language.
• CHWs effectively addressed these barriers by providing education, support, and acting as liaisons between healthcare providers and participants.
• CHWs were integral members of intervention teams, enhancing program engagement.

Conclusions:

• CHW services are crucial for participants with social determinant risk factors but often lack out-of-pocket payment resources.
• Public and private health plans should consider reimbursing CHW services for prediabetes care.
• Integrating CHWs into "community health teams" is essential for effective diabetes prevention.